Though Ebola has been out of the headlines, UPMC remains vigilant against it and other infectious disease threats. The health system’s efforts received an added boost last week following a full-scale drill to test the capabilities of its new Infectious Disease Unit (IDU).
About a dozen county, state and federal health officials observed as UPMC practiced a scenario involving a child and adult suspected of having Ebola.
“The key to emergency preparedness is practice, practice, practice,” said Bill Smith, director of emergency preparedness at UPMC. “Following last week’s drill, I’m confident that our staff and facilities are capable of safely caring for someone with a disease as contagious as Ebola, without putting any patients, visitors or clinicians at risk.”
The recent drill was designed to allow clinicians to physically work through how to put on and take off protective equipment, contain potentially contagious bodily fluids, and communicate with their coworkers – all while caring for a very sick patient.
The scenario, organized by Knox Walk, director of business continuity and preparedness operations at UPMC, played out in a cordoned off section of UPMC Presbyterian Hospital’s Emergency Department, where a trained actor arrived playing an adult with suspected Ebola. The drill then transitioned to the recently completed IDU at UPMC Montefiore Hospital, where a 12-year-old played by a medical simulation mannequin was already receiving care.
Normally the IDU is used as a regular intensive care unit, caring for UPMC’s sickest patients. But, when it becomes necessary to care for a patient with a highly contagious disease, the unit can be cleared and quickly transformed into a specialized unit with two isolation hospital rooms, a laboratory capable of performing diagnostic tests, and separate rooms where clinicians can don and doff protective uniforms and equipment.
Dr. Richard Pan knew he faced an uphill battle last year when his California Senate bill that aimed to ensure more children received immunizations by removing the personal exemption allowance was sent to face three senate committees.
In recounting the story of how the bill was finally passed, the University of Pittsburgh School of Medicine alumnus who is now a California state senator explained during a visit to his alma mater Sunday that typically, bills face only one committee, maybe two. Certainly not three. But, this one was controversial.
“For lay people, the concept of community immunity – herd immunity – is a hard one,” said Dr. Pan, who serves the Senate district encompassing Sacramento. Dr. Pan spoke at Pitt while in town for the recent Medical Alumni Weekend.
In order to get the bill passed, he had to find a way to help his fellow senators understand why immunizing individual children was good for everyone – and vital to their constituencies. That’s when he discovered FRED Measles.
The simulation – optimized for mobile devices – was recently created by scientists at Pitt’s Graduate School of Public Health. Measles vaccination was on the public’s mind following the Disneyland measles outbreak of early 2015, and with a few clicks, users can see what happens in their cities as measles vaccination rates dip too low.
“I was blown away,” said Dr. Pan. “This was exactly what I was looking for. You’d watch as whole cities just exploded in red [as more and more people contracted measles in the simulation demonstrating suboptimal vaccination rates].”
Dr. Pan showed the simulation to any of his fellow legislators who would watch, asking them if they wanted to be responsible for an explosion of measles in their districts. FRED Measles began swaying votes – one senator even confirmed that it was FRED that persuaded him to vote in favor of the bill.
The tide turned and Senate Bill 277 passed the California Senate and was approved by Gov. Jerry Brown at the end of June last year. California now has one of the most comprehensive and protective school-aged child vaccination policies in the country.
“This story perfectly illustrates how public health research can make a real world impact and save lives,” Pitt Public Health dean Dr. Donald S. Burke told Dr. Pan after he told his story. “It is very encouraging to learn that FRED Measles successfully took the difficult idea of herd immunity and turned it into something anyone could understand.”
Emily Young waited more than five years for her liver transplant – a lifesaving gift that came from an unexpected person, someone she never even knew.
As a young child, Young’s appendix ruptured, and she received a blood transfusion. She dealt with many health problems over the years, but it wasn’t until about six years ago that the now 38-year-old was diagnosed with end-stage liver disease.
“The further my disease progressed, the worse I felt,” Young said. “I stayed tired, had no energy and slept all the time. A living donor transplant was my best option.”
More than 120,000 people are currently in need of a lifesaving organ transplant, but last year, there were only 9,000 deceased donors and 6,000 living donors in the U.S. Although 90 percent of Americans say they support organ donation, only 52 percent are registered donors, and even fewer understand the benefits of kidney and liver transplants from living donors.
At the same time that Young was awaiting her liver transplant in Cedar Grove, West Virginia, Laura LeViere of Derry, Pennsylvania had already decided to donate a portion of her liver to the father of a childhood friend. That surgery was scheduled to take place this past spring, but the man unexpectedly died before it could take place.
“I went to visit him before he went home to hospice care, and he began talking to me, letting me know the alarming statistics of people who die waiting for an organ,” said LeViere, also 38. “It was then that I knew I would donate, even if it wasn’t to him.”
Over 15,000 Americans are waiting for a liver, according to national statistics, and more than 1,500 people die each year waiting for a donated liver to become available.
LeViere later contacted one of the transplant coordinators at UPMC and asked to remain on the donor list, which is also known as being an altruistic donor. She received a call toward the end of May that she was a match for a recipient, and the successful transplant surgery took place on June 20.
Shortly after the two women were released from the hospital, they met for the first time.
“I’ve tried to put my feelings into words, to describe the selfless act Laura did for me, my husband and my three children, but there are really no words to describe it,” Young said. “A total stranger gave me the gift of life. She is truly a hero because I will get to sit with my husband and watch my children grow up, something I didn’t think I was going to get to do.”
To be a living donor, a person must be at least 18 years old, in good physical and mental health, and be free of high blood pressure, diabetes, cancer, hepatitis or organ-specific diseases. Donors do not have to be related to the patient to donate a liver or kidney. In fact, the number of unrelated living donors has nearly tripled since 1998.
For more information about living donation, visit the UPMC Transplant Services website. Those interested in being an altruistic donor can call UPMC at 1-800-544-2500 for more information or to schedule an appointment.
In partnership with the Patient Safety Movement Coalition, UPMC and 1,700 hospitals worldwide have made a public and formal commitment to saving lives and promoting a culture of safety by achieving zero preventable deaths by the year 2020.
This commitment was made in support of the Partnership for Patients, an initiative established by the Affordable Care Act (ACA) in 2010 to save lives by averting hospital acquired conditions (HAC) and reducing hospital readmissions.
Last week, Paul Phrampus, M.D., medical director for patient safety at UPMC; Todd Pollock, director of quality at UPMC Presbyterian-Shadyside; and Joe Kiani, founder of the Patient Safety Movement Coalition, held a meeting to discuss the vital role UPMC and clinicians in Pittsburgh are playing in improving patient safety. They met at the Peter M. Winter Institute for Simulation, Education, and Research, which is designed as a hospital setting outfitted with realistic patient simulators, allowing UPMC clinicians to practice and improve their skills.
“Identifying and rectifying situations that may potentially bring harm to a patient requires vigilance, attention to detail, and a culture of safety and transparency,” said Dr. Phrampus. “We strive to empower all staff to make our facilities the safest they can be by speaking up so we can correct these situations.”
This culture of safety, combined with UPMC’s focus on education, training, and competency assessment, is helping to develop solutions and best practices to decrease errors and improve patient safety. Visit the Patient Safety Movement website for a full list of solutions being implemented worldwide to reduce errors and save lives.
“You cannot improve something that you don’t talk about or understand,” Kiani said. “Transparency and reporting of data is key. By investing in understanding the root cause of these errors, UPMC is helping clinicians nationwide make improvements.”
To read more about UPMC and the Patient Safety Movement Coalition’s partnership, as well as the steps being made to reduce patient harm, click here.
Julie Donohue, Ph.D., associate professor of health policy and management at the University of Pittsburgh Graduate School of Public Health, has been working with the state medicate agency to look at the prevalence of opioid overdose in the Pennsylvania Medicaid population. Her pilot grant focuses on lock-in programs that determine the best criteria to identify people who are at risk for abusing prescription opioids, and limit them to filling prescriptions at one pharmacy to prevent “doctor shopping.”
Western Pennsylvania is in the midst of a drug overdose epidemic, prompting Pitt Public Health to create a pilot grant project that funds several studies exploring different aspects of the problem.
This post is part of a blog series entitled “The Opioid Epidemic,” a collaboration between UPMC and the University of Pittsburgh Schools of the Health Sciences highlighting the doctors, researchers and nurses making significant efforts to reduce diversion and misuse of prescription opioids. For more information about the series or resources to help with drug addiction, click here.